Change comes from the bottom up

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It is often the case that companies are faced with a dilemma about whether the change initiatives must be driven from the top or they should be organic from the bottom up. And for those organizations that initiate change from the top, they might find themselves in a situation where the middle and bottom layers of the organizational hierarchy may not be responsive or energized in the way the top managements wants them to be. So, the existential questions as to whether there ought to a spontaneous involvement from all the levels, or whether the top management must induce the change, are very real and need to be answered for change initiatives to succeed.

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Organizational change is difficult. To answer that question, a researcher conducted a two-year ethnographic study of the primary-care departments in two U. Both had received grants to implement the same change throughout their hospitals, but one was dramatically more successful than the other.

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Defining a company's culture can be a difficult task. Although it is a fuzzy concept, it is also very real. Your organization's work culture dictates how your employees think, the manner in which they will respond to a customer, and even whether they will continue in their jobs or leave to join another firm.

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I was meeting with a VP in a large, well-regarded, health care organization this past week. The company has 36 facilities spread over 21 states. He was in charge of something called patient safety meaning working to reduce the number of incidents throughout the system where patients could be harmed due to an error or oversight.

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Log in or sign up to add this lesson to a Custom Course. Log in or Sign up. Your company has been experiencing intense internal conflicts that have started to affect the satisfaction of your clients.

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For this part-2 article, I sat down with three of the Fellows who have been involved in the culture initiative from the beginning to better understand how they got involved and what the work has meant to them. And it is also about a small program within a much bigger health system and the opportunities and challenges that those dynamics create. This includes taking a pulse check on the culture annually and using those data to spark regular discussions about what could be improved.

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Ideally your approach to change would be personal! Yet, today we still see many leaders using Top Down Change as the default approach without considering the impact on productive relationships. None of us work in a vacuum.

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The most effective senior managers in our study recognized their limited power to mandate corporate renewal from the top. Instead, they defined their roles as creating a climate for change, then spreading the lessons of both successes and failures. Put another way, they specified the general direction in which the company should move without insisting on the specific solutions. Organization change and improvement planning calls for systems, processes, and discipline.

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By Jesper Toft Madsen If you see no behavioural change among practitioners acting as front-line staff four years after having launched a reform, well, then you stare failure in the face. The risk and actual failure of large-scale change projects in the public sector is a well-known phenomenon. Although politicians, executives, scientists, consultancies and practitioners have all attempted to grasp the complex ecosystem of implementation for decades, failure continues to haunt and hamper the development of even the most sophisticated welfare states.

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Real change occurs from the bottom up; it occurs person to person, and it almost always occurs in small groups and locales and then bubbles up and aggregates to larger vectors of change. Sign Up. My Account.


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